Common carotid artery pseudoaneurysm and frontal brain abscess secondary to oesophageal foreign body in a paediatric patient

Young children often present with sharp foreign body (FB) ingestion. While the risk of complications is low when the FB is urgently removed, perforation of the gastrointestinal tract may lead to further interventions and treatments. A boy between 12 and 24 months old presented to the emergency department with a safety pin lodged within his mid-oesophagus. Nine days following removal, he had developed a right common carotid pseudoaneurysm (PSA) and right frontal brain abscess due to unrecognised oesophageal perforation by the FB. He underwent a burr hole craniotomy for the brain abscess and right common carotid artery repair for the PSA, both of which were technically successful. Two years later, he shows no evidence of any PSA in his common carotid artery and experiences no neurological defects. This case highlights the need for early management of sharp FB-related cases in children and the critical role of close follow-up and multidisciplinary surgical care in treating further complications.